Cardiovascular disease risk factors and left ventricular hypertrophy in girls and boys with CKD

Rebecca Ruebner, Derek Ng, Mark Mitsnefes, Bethany J. Foster, Kevin Meyers, Bradley Warady, Susan L. Furth

Research output: Contribution to journalArticle

Abstract

Background and objectives Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD. Design, setting, participants, and measurements The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined as LVM/height2.7>95th percentile and LVM relative to estimated lean body mass (eLBM)>95th percentile for age and sex. Differences in LVM by sex were assessed by adjusting for age, weight, height, and eLBM using bivariate and multivariate regression models. Results Girls were less likely to have uncontrolled hypertension (26% versus 38%, P=0.001), had lower diastolic BP z-scores (+0.3 versus +0.6, P=0.001), and had lower prevalence of high triglycerides (38% versus 47%, P=0.03) compared with boys. When LVH was defined by LVM indexed to height, girls had higher prevalence of LVH (16% versus 9%, P=0.01); when LVH was defined by LVM relative to eLBM, prevalence of LVH was similar between girls and boys (18% versus 17%, P=0.92). In regression models adjusting for eLBM, no sex differences in LVM were observed. Conclusions Despite lack of increased prevalence of CVD risk factors, indexing LVM to height showed a higher proportion of LVH among girls, while estimates of LVH based on eLBM showed no sex differences. Indexing LVM to eLBM may be an alternative to height indexing in children with CKD.

Original languageEnglish (US)
Pages (from-to)1962-1968
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume11
Issue number11
DOIs
StatePublished - 2016

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Left Ventricular Hypertrophy
Cardiovascular Diseases
Sex Characteristics
Body Size
Chronic Renal Insufficiency
Triglycerides
Hypertension
Weights and Measures
Mortality
Population

Keywords

  • Body Size
  • Body Weight
  • cardiovascular disease
  • child
  • chronic kidney disease
  • female
  • Humans
  • hypertension
  • Hypertrophy, Left Ventricular
  • left ventricular hypertrophy
  • Male
  • pediatric nephrology
  • Prevalence
  • Renal Insufficiency, Chronic
  • risk factors
  • Sex Characteristics
  • Triglycerides

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Cardiovascular disease risk factors and left ventricular hypertrophy in girls and boys with CKD. / Ruebner, Rebecca; Ng, Derek; Mitsnefes, Mark; Foster, Bethany J.; Meyers, Kevin; Warady, Bradley; Furth, Susan L.

In: Clinical Journal of the American Society of Nephrology, Vol. 11, No. 11, 2016, p. 1962-1968.

Research output: Contribution to journalArticle

Ruebner, Rebecca ; Ng, Derek ; Mitsnefes, Mark ; Foster, Bethany J. ; Meyers, Kevin ; Warady, Bradley ; Furth, Susan L. / Cardiovascular disease risk factors and left ventricular hypertrophy in girls and boys with CKD. In: Clinical Journal of the American Society of Nephrology. 2016 ; Vol. 11, No. 11. pp. 1962-1968.
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abstract = "Background and objectives Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD. Design, setting, participants, and measurements The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined as LVM/height2.7>95th percentile and LVM relative to estimated lean body mass (eLBM)>95th percentile for age and sex. Differences in LVM by sex were assessed by adjusting for age, weight, height, and eLBM using bivariate and multivariate regression models. Results Girls were less likely to have uncontrolled hypertension (26{\%} versus 38{\%}, P=0.001), had lower diastolic BP z-scores (+0.3 versus +0.6, P=0.001), and had lower prevalence of high triglycerides (38{\%} versus 47{\%}, P=0.03) compared with boys. When LVH was defined by LVM indexed to height, girls had higher prevalence of LVH (16{\%} versus 9{\%}, P=0.01); when LVH was defined by LVM relative to eLBM, prevalence of LVH was similar between girls and boys (18{\%} versus 17{\%}, P=0.92). In regression models adjusting for eLBM, no sex differences in LVM were observed. Conclusions Despite lack of increased prevalence of CVD risk factors, indexing LVM to height showed a higher proportion of LVH among girls, while estimates of LVH based on eLBM showed no sex differences. Indexing LVM to eLBM may be an alternative to height indexing in children with CKD.",
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T1 - Cardiovascular disease risk factors and left ventricular hypertrophy in girls and boys with CKD

AU - Ruebner, Rebecca

AU - Ng, Derek

AU - Mitsnefes, Mark

AU - Foster, Bethany J.

AU - Meyers, Kevin

AU - Warady, Bradley

AU - Furth, Susan L.

PY - 2016

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N2 - Background and objectives Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD. Design, setting, participants, and measurements The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined as LVM/height2.7>95th percentile and LVM relative to estimated lean body mass (eLBM)>95th percentile for age and sex. Differences in LVM by sex were assessed by adjusting for age, weight, height, and eLBM using bivariate and multivariate regression models. Results Girls were less likely to have uncontrolled hypertension (26% versus 38%, P=0.001), had lower diastolic BP z-scores (+0.3 versus +0.6, P=0.001), and had lower prevalence of high triglycerides (38% versus 47%, P=0.03) compared with boys. When LVH was defined by LVM indexed to height, girls had higher prevalence of LVH (16% versus 9%, P=0.01); when LVH was defined by LVM relative to eLBM, prevalence of LVH was similar between girls and boys (18% versus 17%, P=0.92). In regression models adjusting for eLBM, no sex differences in LVM were observed. Conclusions Despite lack of increased prevalence of CVD risk factors, indexing LVM to height showed a higher proportion of LVH among girls, while estimates of LVH based on eLBM showed no sex differences. Indexing LVM to eLBM may be an alternative to height indexing in children with CKD.

AB - Background and objectives Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD. Design, setting, participants, and measurements The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined as LVM/height2.7>95th percentile and LVM relative to estimated lean body mass (eLBM)>95th percentile for age and sex. Differences in LVM by sex were assessed by adjusting for age, weight, height, and eLBM using bivariate and multivariate regression models. Results Girls were less likely to have uncontrolled hypertension (26% versus 38%, P=0.001), had lower diastolic BP z-scores (+0.3 versus +0.6, P=0.001), and had lower prevalence of high triglycerides (38% versus 47%, P=0.03) compared with boys. When LVH was defined by LVM indexed to height, girls had higher prevalence of LVH (16% versus 9%, P=0.01); when LVH was defined by LVM relative to eLBM, prevalence of LVH was similar between girls and boys (18% versus 17%, P=0.92). In regression models adjusting for eLBM, no sex differences in LVM were observed. Conclusions Despite lack of increased prevalence of CVD risk factors, indexing LVM to height showed a higher proportion of LVH among girls, while estimates of LVH based on eLBM showed no sex differences. Indexing LVM to eLBM may be an alternative to height indexing in children with CKD.

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KW - pediatric nephrology

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